Paid by the amount of patients

  1. Hi everyone!
    I have been working as a NP for a couple months in a clinic part time at an hourly rate. I plan on transitioning to full time mid jan 2016. My options of ways to get paid is by hourly, salary, or the amount of patient I see. The person in charge of my salary has ask me to come up with a model if I was to get paid by the amount of patients I see when I become full time in the next month. This is really how he would prefer me to get paid. Has anyone ever been paid this way? If so, how did it work? I am just trying to the most I can because I see a ton of patients daily.
    If anyone could give suggestions, this would help me a bunch. There is no lack of patients and I am only seeing follow ups and adjusting meds accordingly.

    Thanks!
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  2. 13 Comments

  3. by   sailornurse
    What is a "ton" of patients? What are they offering if salaried? And what other benefits (401K, how many weeks vacation/sick leave? CME-How much & how many days per year? Who pays for DEA/pharmacy licenses/RN/NP licenses? What ever method the employer is offering is usually in their favor. Are you W-2 employee or 1099 independent contractor?
  4. by   jer_sd
    Will it be a flat fee per pt or a % of collections? What cpt codes are billed the most frequently and what is the typical reimbursement? What support is provided (scheduling, assistants, ect).

    Once you understand the revenue you generate and the overhead it can allows you to have a better idea.
  5. by   bhudgins
    Around 30 patients daily. All follow ups. $80,000 if salaried. W-2 employee. 2 weeks of vacation/sick leave. Other benefits include paying for my insurance. Im W-2 employee. They [paid for my malpractice insurance. I already had the other license.
  6. by   sailornurse
    80K is very low balled offer. You are not getting hardly any benefits. Are you going to sign a contract? 2 weeks vacation is ok but you should ask for another 5 days for sick leave. Vacation & sick leave are 2 separate items. So they are paying for health insurance? Good that they pay for malpractice insurance. So you already have your nursing license? Great. But part of negotiating is asking that they pay for license renewals, both RN, NP. I just renewed, my Rn license cost $93.00, NP license $100. DEA number again is costing $731 and is good for 3 years, who is paying for that. Also you need a pharmacy license. ($60 annually) Now, what about Continuing Education? How many CEUs are you required to have? (In NM I need 50 ceus, so I go to one major conference), Ask for $1500 to attend a conference (hotel/airfare or rental car plus cost of conference/meals/gas) and 5 days to get your CEUs. Please do not just take what they offer. Also, my ANCC recert every 5 years, there is a cost to renew. All of this should be paid by employer. Please do a search on this, (JulesA is a fierce negotiator if you PM her, she might be willing to give you some tips). To me it sounds like you are going to take what they offer. What state are you in?
    Last edit by sailornurse on Dec 11, '15
  7. by   bhudgins
    I am in Alabama. I do not just want to take what I am offered. That's why I asking questions. I am new at this!! I just want to know whats common where I can ask for it soon because its a little bit over a month before I become fulltime and I don't want to be ripped off. I appreciate everyones input!!
  8. by   Dogen
    I never get tired of reading these threads. I wish they taught us this stuff in NP school. I've spent the last year grilling every NP I meet to find out their "if I knew then what I know now" moments regarding contracts in order to be better informed. So, thanks everybody.
  9. by   Hi2Jenn
    If you don't have dips in patient levels, i.e. in the summer only 10 a day, then 80K is definitely low ball. You are better off with per patient's seen. However, that can be done per RVU (Each CPT code has an RVU) or percentage of patient's billed. Find out if you're paid when you do the visits or when they get paid by insurance. If percentage billed, what is their average payment?
    Two weeks is not enough time off. Trust me on this one.
    Definitely have them pay all licenses, renewals, and certifications. Mine even pays my membership in professional organizations.
    CEU - 5 days and $1500 is standard. FYI.
  10. by   missdeevah
    What did you end up asking for?
  11. by   LaraRN86
    This is something that has been on my mind as well. I am currently in NP school, and my friend graduated a few months ago and is looking for her first job. She was asked the same scenario. I will be following this thread.
  12. by   Rocknurse
    Why is this stuff never mentioned in school? How come med students seem to know all the intricacies about revenue but we seem to be clueless? This information is so valuable to newly graduating NPs and can only help to keep everybody's wages higher. Nobody wants some new grad accepting some ridiculous $70,000 offer and undercutting them just to find out the experienced NP is being let go because new grads are cheaper. That's exactly what's happening with RNs all over the country. We cannot let that happen to NPs.
  13. by   BostonFNP
    My program had to seminars on this.

    You can almost never go wrong with getting paid by what you bring in: getting 40-45% of the money you brought is about average (it's how many physician contracts are calculated). Then negotiate your benefits. If you are seeing 30 level 3 patients in follow-up (most places bill level 4s for follow-up) you be making $948 per day, using medicare numbers. If you are seeing 10 a day then it's $316/day.
  14. by   gettingbsn2msn
    Same situation here. And they want me to run ads in the local newsletter introduce This, and the owner is not even in healthcare. i think it is becoming the norm for this area. I keep hearing i could get an lpn for what you do.

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